According to the World Health Organisation’s International Agency for Research on Cancer, regular mammogram screening could reduce deaths from breast cancer by 35%.
BREAST cancer is the most common cancer in women in most parts of the world. There is a geographical variation, with the highest incidence in North America and North Europe, an intermediate incidence in South America and South Europe, and a lower incidence in Asia and Africa.
According to the Malaysian Second Report of the National Cancer Registry, there were 3,738 cases in 2003. It was the commonest cancer in all ethnic and age groups of Malaysian women, comprising 31.0% of all cases reported.
The peak incidence was in the 50 to 59 years age group, with a decline in older age groups. About 64.1% of all cases were diagnosed in women aged between 40 and 60 years.
Seeing lumps: A mammogram is an X-ray of the breasts. It can be used to detect breast cancer in women who have no signs or symptoms, in which case it is called a screening mammogram.
Many women regard the breast as a badge of their femininity, and they can be markedly affected psychologically if they have breast cancer. Experience worldwide has shown that its early detection and treatment helps in making possible a high cure rate.
Mammograms play an important role in the screening and diagnosis of breast cancer and other breast conditions. According to the World Health Organisation’s (WHO) International Agency for Research on Cancer (IARC), regular screening could reduce deaths from breast cancer by 35%.
A mammogram is an X-ray of the breasts. It can be used to detect breast cancer in women who have no signs or symptoms, in which case it is called a screening mammogram. When it is used for diagnosis in women who have signs and symptoms of breast disease, e.g. a lump, pain, nipple discharge, or change in breast size or shape, it is called a diagnostic mammogram.
A screening mammogram usually entails the taking of two X-ray images of each breast to detect lumps that are not felt on touch. Small amounts of calcium (microcalcifications), which occasionally is indicative of breast cancer, can also be detected.
A diagnostic mammogram is used when there are signs or symptoms of breast disease. It is also used to evaluate images detected in a screening mammogram or when there is difficulty in doing a screening mammogram, e.g. presence of breast implants. It entails the taking of more X-rays to obtain images from various angles. Hence, more time is required than a screening mammogram.
The images obtained in a mammogram are stored on film or digitally. In the case of the latter, the images stored in a computer can be magnified, enhanced, or manipulated for detailed assessment, which is not possible with images stored on film.
This has the advantage of assessing subtle image differences, assessment at another site (teleradiology), and fewer repeat X-rays, leading to a decreased radiation exposure.
There is no difference in the procedure for conventional film or digital mammography.
Mammogram
The patient is asked to remove the top of her dress by a female radiographer. Each breast is placed firmly between two small plates of an X-ray device, one at a time. The compression of the breast facilitates the taking of clear X-ray images.
Some women find this uncomfortable, others find it painful. However, the discomfort is transient, i.e. only during the compression of the breast. There is evidence that discomfort or pain is reduced by quality information about the procedure and control over the breast compression.
Painkillers (analgesics) are not helpful.
Two X-rays are usually taken in a screening mammogram, one from above, and the other from the side. This process doubles the cancer detection rate.
The X-ray images are assessed by a specialist (radiologist). If the images are not clear, or abnormalities are found, the patient will be asked to return for additional X-rays.
The time taken for the report to be available depends on the healthcare facility. It is natural to have some degree of anxiety while waiting for the result of a mammogram, which will be reported by the radiologist.
